Shear bond strength of different types of adhesive systems to dentin and enamel of deciduous teeth in vitro

Bond strength and marginal adaptation of resin composites and correlations with clinical results

OBJECTIVES

Due to innumerable confounding factors and a high number of types and brands of dental restorative materials, the clinical performance of restorative materials are sought predicted by various in vitro tests. However, only few such tests have been found to correlate well with clinical findings. Thus, the present study determined the in vitro dentin bond strength and marginal adaptation of Class II restorations and correlated the results to their clinical outcomes.

METHODS

Dentin bond strength (µTBS and µSBS) and marginal gap formation of Class II restorations (replica technique and SEM) were measured after 24 h and 6 m water storage using eight combinations of adhesive and resin composite. Clinical outcomes (mean survival time, Hazard Ratio, annual failure rate; n = 10.695) were gained from a data set of a retrospective multicenter study of direct restorations.

RESULTS

Significant differences were found for dentin bond strength and marginal gap formation between the restorative material groups, and negative effects of long-term storage were observed. µTBS correlated significantly with certain clinical outcomes of Class I restorations, while µSBS correlated with certain clinical outcomes of Class II, III, IV and V restorations. Marginal gap formation in enamel and number of paramarginal fractures correlated with certain clinical outcomes of Class II restorations.

SIGNIFICANCE

Using the same restorative materials in vitro as in vivo, gave significant, but weak correlations between in vitro bond strength or marginal adaptation and clinical outcomes, lending support to the use of in vitro tests in early stages of material selection.

Synthesis, monomer conversion, and mechanical properties of polylysine based dental composites

OBJECTIVE

The aim of this study was to synthesize a new bioactive and antibacterial composite by incorporating reactive calcium phosphate and antibacterial polylysine into a resin matrix and evaluate the effect of these fillers on structural analysis, degree of monomer conversion, mechanical properties, and bioactivity of these newly developed polypropylene based dental composites.

METHODOLOGY

Stock monomers were prepared by mixing urethane dimethacrylate and polypropylene glycol dimethacrylate and combined with 40 wt% silica to make experimental control (E-C). The other three experimental groups contained a fixed percentage of silica (40 wt%), monocalcium phosphate monohydrate, and β-tri calcium phosphate (5 wt% each) with varying amounts of polylysine (PL). These groups include E-CCP0 (0 wt% PL), E-CCP5 (5 wt% PL) and E-CCP10 (10 wt% PL). The commercial control used was Filtek™ Z250 3M ESPE. The degree of conversion was assessed by using Fourier transform infrared spectroscopy (FTIR). Compressive strength and Vicker's micro hardness testing were evaluated after 24 h of curing the samples. For bioactivity, prepared samples were placed in simulated body fluid for 0, 1, 7, and 28 days and were analyzed using a scanning electron microscope (SEM). SPSS 23 was used to analyze the data and one-way ANOVA and post hoc tukey's test were done, where the significant level was set ≤0.05.

RESULTS

Group E-C showed better mechanical properties than other experimental and commercial control groups. Group E-C showed the highest degree of conversion (72.72 ± 1.69%) followed by E-CCP0 (72.43 ± 1.47%), Z250 (72.26 ± 1.75%), E-CCP10 (71.07 ± 0.19%), and lowest value was shown by E-CCP5 (68.85 ± 7.23%). In shear bond testing the maximum value was obtained by E-C. The order in decreasing value of bond strength is E-C (8.13 ± 3.5 MPa) > Z250 (2.15 ± 1.1 MPa) > E-CCP10 (2.08 ± 2.1 MPa) > E-CCP5 (0.94 ± 0.8 MPa) > E-CCP0 (0.66 ± 0.2 MPa). In compressive testing, the maximum strength was observed by commercial control i.e., Z250 (210.36 ± 18 MPa) and E-C (206.55 ± 23 MPa), followed by E-CCP0 (108.06 ± 19 MPa), E-CCP5 (94.16 ± 9 MPa), and E-CCP10 (80.80 ± 13 MPa). The maximum number of hardness was shown by E-C (93.04 ± 8.23) followed by E-CCP0 (38.93 ± 9.21) > E-CCP10 (35.21 ± 12.31) > E-CCP5 (34.34 ± 12.49) > Z250 (25 ± 2.61). SEM images showed that the maximum apatite layer as shown by E-CCP10 and the order followed as E-CCP10 > E-CCP5 > E-CCP0 >Z250> E-C.

CONCLUSION

The experimental formulation showed an optimal degree of conversion with compromised mechanical properties when the polylysine percentage was increased. Apatite layer formation and polylysine at the interface may result in remineralization and ultimately lead to the prevention of secondary caries formation.

Effect of Er: YAG laser irradiation with additional low energy on resin-dentin bonding and morphology of bonded interface

OBJECTIVES

To examine the micro tensile bond strength (μTBS) and the resin-dentin interface on a laser-irradiated dentin surface using two different irradiation methods, with or without additional low-energy irradiation.

METHODS

The flat bovine dentin surface was divided into three groups: i). control group (C group, no irradiation), ii) 80 mJ/pulse Er: YAG laser group (80 group), iii) 80 + 30 mJ/pulse Er: YAG laser group (80 + 30 group, with an additional 30 mJ/pulse). After the roughness of the dentin surface was recorded, Clearfil SE Bond 2 or Clearfil Universal Bond Quick (Kuraray Noritake Dental Inc., Tokyo, Japan) was applied. After the μTBS testing, the failure mode was observed. The bonded interface was assessed using Rhodamine-dye incorporated adhesives and observed by optical coherence tomography.

RESULTS

The dentin surface showed opened dentinal tubules without a smear layer after irradiation. For both adhesives, the μTBS was significantly higher in 80 + 30 group than in the 80 group (p < 0.05). In the 80 group, the thickness of the adhesive layer was not uniform, and the dentin surface was occasionally in direct contact with the composite resin. The failure mode images showed that most of the fractures in the 80 group were at the sub-surface of irradiated dentin. The adhesive layers of the 80 + 30 groups were homogeneous.

CONCLUSIONS

The dentin surface was rough and irregular by 80 mJ irradiation, which might result in an inadequate resin-dentin interface and the weak μTBS. The bonded integrity was mitigated by additional irradiation.

Shear Bond Strength and Fluoride Release of a Universal Adhesive: An In-Vitro Study on Primary Teeth

This investigation aimed to assess the shear bond strength and fluoride-releasing capabilities of Clearfil Universal Bond Quick (Kuraray Noritake Dental Inc., Tokyo, Japan). Forty-four extracted primary molars were divided into two groups, and the enamel substrate was prepared for evaluating shear bond strength. Scotchbond (3M ESPE) and Clearfil UBQ were used to bond composite-to-enamel substrates in each group (n = 22). Shear bond strength was measured using a universal testing device and compared. Sixteen discs (6 mm diameter and 3 mm thickness) were fabricated from each Clearfil UBQ, Fuji IX, and Fuji II LC. Over the course of 30 days, each materials' fluoride release was examined and compared using ion analysis. Results revealed that Clearfil UBQ had statistically similar shear bond strength to Scotchbond. Between the three materials, Clearfil UBQ had the lowest fluoride release at baseline (0.11 ± 0.25) and the lowest cumulative fluoride release (0.12-0.27 ppm) over 30 days. Fuji IX had the highest fluoride release at baseline (19.38 ± 2.50) and cumulatively (40.87 ± 4.03 ppm), followed by Fuji II LC. We conclude that Clearfil UBQ and Scotchbond showed comparable bond strengths to the enamel. Fluoride release was seen in Clearfil UBQ in the initial two days of the 30-day period. The amount of fluoride release was significantly less than with glass ionomer cements.

Exploration and preliminary clinical investigation of an adhesive approach for primary tooth restoration

The current study aims to investigate a suitable adhesive for primary tooth enamel. Shear bond strength (SBS) of primary teeth and the length of resin protrusion were analyzed using one-way ANOVA with Bonferroni multiple comparison tests after etching with 35% H ₃PO ₄. SBS and marginal microleakage tests were conducted with Single Bond Universal (SBU)/Single Bond 2 (SB2) adhesives with or without pre-etching using a nonparametric Kruskal-Wallis test. Clinical investigations were performed to validate the adhesive for primary teeth restoration using Chi-square tests. Results showed that the SBS and length of resin protrusion increased significantly with the etching time. Teeth in the SBU with 35% H ₃PO ₄ pre-etching groups had higher bond strength and lower marginal microleakage than those in the SB2 groups. Mixed fractures were more common in the 35% H ₃PO ₄ etched 30 s + SB2/SBU groups. Clinical investigations showed significant differences between the two groups in cumulative retention rates at the 6-, 12- and 18-month follow-up evaluations, as well as in marginal adaptation, discoloration, and secondary caries at the 12- and 18-month follow-up assessments. Together, pre-etching primary teeth enamel for 30 s before SBU treatment improved clinical composite resin restoration, which can provide a suitable approach for restoration of primary teeth.

Enhancing adhesive-dentin interface stability of primary teeth: From ethanol wet-bonding to plant-derived polyphenol application

OBJECTIVES

To investigate whether the adhesive-dentin interface stability of primary teeth would be enhanced by epigallocatechin-3-gallate (EGCG) with ethanol wet-bonding.

METHODS

Non-caries primary molars were sliced to achieve a flat dentin surface and etched then randomly distributed into five groups in accordance with different treatments: group 1, no treatment; group 2, applying absolute ethanol wet-bonding for 60 s; groups 3-5, applying 0.1%, 0.5%, and 1% (w/v) EGCG-incorporating ethanol wet-bonding (0.1%, 0.5%, and 1% EGCG) for 60 s. Singlebond universal adhesive was then applied followed by resin composite construction. Microtensile bond strength, fracture mode, and nanoleakage at adhesive-dentin interface were evaluated after 24 h of water storage or 10,000 times of thermocycling. Zymography of hybrid layer, biofilm formation of Streptococcus mutans by CLSM, FESEM, and MTT test, and cytotoxicity by CCK-8 assay were respectively assessed.

RESULTS

Irrespective of thermocycling, the dentin bond strength was preserved with reduced nanoleakage in the 0.5% and 1% EGCG groups. Furthermore, the activity of endogenous proteases and the growth of Streptococcus mutans biofilm were inhibited after treatment with 0.5% and 1% EGCG/ethanol solutions (groups 4 and 5). CCK-8 results of the 0.1% and 0.5% EGCG groups showed acceptable biocompatibility.

CONCLUSIONS

Treatment by EGCG/ethanol solutions effectively enhanced the bond stability of primary teeth at the adhesive-dentin interface.

CLINICAL SIGNIFICANCE

Synergistic application of EGCG and ethanol wet-bonding suggesting a promising strategy to improve dentin bonding durability with bacterial biofilm inhibition, thus increasing resin-based restorations' service life in primary dentition.

Effectiveness of sodium hypochlorite treatment on the bonding of four adhesive systems to fluorotic enamel

The study evaluated the effect of sodium hypochlorite (NaOCl) treatment on fluorotic enamel bonding of four adhesive systems. They were Single Bond 2 (SB2), Prime&Bond NT (PBN), Clearfil SE Bond (CSB), and Single Bond Universal (SBU). One hundred eighteen extracted moderate fluorotic molars were divided into eight groups according to NaOCl pretreatment and four adhesive systems. The microshear bond strength (μSBS), etching pattern, and penetration depth (PD) were observed. The statistical method was two-way ANOVA and least significant difference (LSD) test (α=0.05). The application of NaOCl significantly increased the μSBS of PBN and SBU (p<0.05). The enamel-etching pattern of CSB and SBU was deeper under SEM. A noticeable increase of PD was in SB2 and SBU after the application of NaOCl (p<0.05). Pretreatment of 5.25% NaOCl for the 60 s can increase μSBS of PBN and SBU, PD of SB2 and SBU, and improve enamel-etching pattern of CSB and SBU to fluorotic enamel.

Influence of TiO2 and ZrO2 Nanoparticles on Adhesive Bond Strength and Viscosity of Dentin Polymer: A Physical and Chemical Evaluation

The present study aimed to formulate an experimental adhesive (EA) and reinforce it with 5 wt.% titanium dioxide (TiO₂) or zirconium oxide (ZrO₂) to yield 5% TiO₂ and 5% ZrO₂ adhesives, respectively, and then analyze the impact of this reinforcement on various mechanical properties of the adhesives. The EA contained a blend of monomers such as bisphenol A glycol dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA), 2-hydroxyethyl methacrylate (HEMA), and ethyl 4-dimethylamino benzoate and camphorquinone. The EA included ethyl 4-dimethylamino benzoate and camphorquinone photo-initiators, and diphenyliodonium hexafluorophosphate (DPIHP) was also included to act as an electron initiator. The TiO₂ and ZrO₂ nanoparticles were incorporated into the EA post-synthesis. To characterize the filler nanoparticles, scanning electron microscopy (SEM) and line-energy dispersive X-ray (EDX) spectroscopy were performed. The adhesives were characterized by analyzing their rheological properties, shear-bond strength (SBS), and interfacial failure types. Further, the resin-dentin interface was also analyzed via SEM. The TiO₂ nanoparticles were spherically shaped on the SEM micrographs, while the ZrO₂ nanoparticles were seen as non-uniformly shaped agglomerates. The EDX mapping demonstrated the presence of Ti and oxygen for TiO₂ and Zr and oxygen for the ZrO₂ nanoparticles. Both 5% TiO₂ and 5% ZrO₂ adhesives revealed decreased viscosity as compared with the EA. The 5% TiO₂ adhesive demonstrated higher SBS values for both non-thermocycled (NTC) and thermocycled samples (NTC: 25.35 ± 1.53, TC: 23.89 ± 1.95 MPa), followed by the 5% ZrO₂ adhesive group (NTC: 23.10 ± 2.22, TC: 20.72 ± 1.32 MPa). The bulk of the failures (>70%) were of adhesive type in all groups. The SEM analysis of the resin-dentin interface revealed the development of a hybrid layer and resin tags (of variable depth) for the EA and 5% TiO₂ groups. However, for the 5% ZrO₂ group, the hybrid layer and resin tag establishment appeared compromised. Reinforcement of the EA with TiO₂ or ZrO₂ caused an increase in the adhesive's SBS (with the 5% TiO₂ group demonstrating the highest values) in comparison with the EA (without nanoparticles). However, both nanoparticle-containing adhesives revealed decreased viscosity compared with the EA (without nanoparticles). Further studies investigating the impact of diverse filler concentrations on the properties of adhesives are suggested.

Repair potential of a bulk-fill resin composite: Effect of different surface-treatment protocols

This study evaluated the effect of different surface-treatment protocols on the repair bond strength of a bulk-fill resin composite. One-hundred and forty specimens (Filtek Bulk-fill) were created (5 mm diameter, 4 mm depth) and allocated to one of 14 groups according to surface treatment (no treatment, tribochemical silica coating, sandblasting with aluminum oxide), adhesive application (no adhesive, total-etch, self-etch), and type of repair resin (bulk-fill, universal resin) (n = 10 per group). Twenty specimens were selected for measuring the cohesive strengths of non-aged resin composites and used as reference. Other specimens were thermocycled. Shear bond-strength testing was performed. Data were analyzed using linear regression of bond strength as a function of the surface treatment, type of adhesive and whether or not adhesive was applied, and type of repair resin. The failure modes were analyzed using logistic regression of failure mode (cohesive failure vs. other types, or adhesive failure vs. other types) on the type of surface treatment, adhesive application, and repair resin used. Surface treatment, regardless of whether this was tribochemical silica coating (mean difference = 5.44 MPa; 95% CI = 4.77-6.11) or sandblasting with aluminum oxide (mean difference = 4.22 MPa; 95% CI = 3.55-4.88), resulted in higher shear bond strength than no treatment. Application of adhesive resulted in a substantial and statistically significant decrease of shear bond strength (by 8.77 MPa, for self-etch and by 7.26 MPa for total-etch) relative to no adhesive. Conversely, the type of repair resin did not influence the shear bond strength to any appreciable extent.

Micro Push-Out Bond Strength of Resin Composite to Dentin in Primary Dentition Using Three Universal Adhesives with Different pH: An In Vitro Study

To evaluate the bond strength of different universal adhesives on deciduous tooth dentineand their relationship with the composition and potential of hydrogen (pH). Methods: An in vitromicro push-out test on 150 samples (n = 50) per group per adhesive, namely, Adhese Universal(ADH; Ivoclar Vivadent), Futurabond U (FUT; Voco GmbH) (Test), and Scotchbond Universal withpre-conditioning (SCO; 3M) (Control), to record bond strength (BS) and type of adhesive failure.Results: The results of the different adhesives (megapascals (MPa)) varied, showing no statisticalsignificance. The corresponding averages are in MPa: ADH, 13.66 2.81; FUT, 14.48 2.88; SCO,14.98 3.96. Additionally, the frequency of type of failure was as follows: mixed (60.7%), adhesive(27.3%), and cohesive (12%). Conclusions: SCO, with a pH of 2.7, showed greater resistance tofracture, while FUT, with a pH of 2.3 and no pre-conditioning, approached the same values, being aone-step adhesive. No relationship was found between failure and type of adhesive.

Influence of ER-CR-YSGG Laser and Photodynamic Therapy on the Dentin Bond Integrity of Nano-Hydroxyapatite Containing Resin Dentin Adhesive: SEM-EDX, Micro-Raman, Micro-Tensile, and FTIR Evaluation

The study aimed to analyze the effect of the addition of nano-hydroxyapatite (nano-HA) particles on the mechanical properties of experimental adhesive (EA). Furthermore, dentin interaction of EA (without nano-HA) and EA with nano-HA (hereon referred to as HA-10%) were also investigated and equated. Methods consisting of scanning electron microscopy (SEM)-energy-dispersive X-ray spectroscopy (EDX), micro-Raman spectroscopy, micro-tensile bond strength (µTBS) test, and Fourier transform infrared (FTIR) spectroscopy were employed to study nano-HA particles shape, dentin bond strength, degree of conversion (DC), and adhesive-dentin interaction. Ninety teeth (N = 90) were collected, and pre-bonding, conditioning of dentin was performed utilizing phosphoric acid (H₃PO₄) etching, photodynamic therapy (PDT), and ER-CR-YSGG (ECY) laser. The teeth were set to form bonded specimens using two adhesives. Nano-HA particles were spherical-shaped, and EDX confirmed the presence of oxygen, calcium, and phosphorus. Micro-Raman spectroscopy revealed distinct phosphate and carbonate peaks for nano-HA. The µTBS test demonstrated highest values for HA-10% group on the H₃PO₄ conditioned dentin. The greatest DC was observed for the EA group. The addition of nano-HA-10 wt.% particles in dentin adhesive resulted in improved bond strength. The incorporation also demonstrated acceptable DC (although lower than EA group), suitable dentin interaction, and resin tag formation.

Synergistic effect of graphene oxide/calcium phosphate nanofiller in a dentin adhesive on its dentin bond integrity and degree of conversion. A scanning electron microscopy, energy dispersive X-ray spectroscopy, Fourier transform infrared, micro-Raman, and bond strength study

The objective was to formulate and analyze a dentin adhesive incorporated with graphene oxide (GO) nanoparticle and calcium phosphate (CaP) composite. Methods comprising of scanning electron microscopy (SEM)-energy dispersive X-ray spectroscopy (EDX), micro-Raman spectroscopy, shear bond strength (SBS), and Fourier transform infrared (FTIR) spectroscopy were used to characterize nanoparticle composite, dentin bond toughness, degree of conversion (DC), and adhesive-dentin interaction. Postsynthesis of GO nanoparticles, they were functionalized with CaP using standard process. The GO-CaP composite was not added to experimental adhesive (negative control group, GO-CaP-0%), and added at 2.5 and 5 wt% to yield GO-CaP-2.5% and GO-CaP 5% groups, respectively. Teeth were set to form bonded samples utilizing adhesives in three groups for SBS testing, with and without thermocycling. The homogenous diffusion of GO-CaP composite was verified in the adhesive. Resin tags having standard penetrations were observed on SEM micrographs. The EDX analysis confirmed the occurrence of calcium, phosphorus, and carbon ions in the composite containing adhesives. The SBS test revealed highest mean values for GO-CaP-5% followed by GO-CaP-2.5%. The FTIR spectra verified the presence of apatite peaks and the micro-Raman spectra showed characteristic D and G bands for GO nanoparticles. GO-CaP composite in dentin adhesive may improve its bond strength. The addition of 5 wt% resulted in a bond strength that was superior to all other groups. GO-CaP-5% group demonstrated lower DC (to control), uniform distribution of GO and CaP composite within adhesive, appropriate dentin interaction, and resin tag formation.

Effects of Er:YAG laser pre-treatment on dentin structure and bonding strength of primary teeth: an in vitro study

Background

To investigate the effects of Er:YAG laser pre-treatment on the dentin structure and shear bond strength of primary teeth.

Methods

Dentin specimens were prepared using freshly extracted intact primary molars and divided randomly into four groups based on the surface treatment applied. The control and etchant groups received no treatment and conventional acid etching treatment, respectively, while the energy and frequency groups received laser surface treatment with variable energy (50–300 mJ) and frequency (5–30 Hz) parameters. The morphology was observed using scanning electron microscopy. The surface-treated dentin slices were bonded to resin tablets, followed by thermocycle treatment. The shear strength was determined using a universal testing machine and de-bonded surfaces were observed using a stereomicroscope.

Results

SEM observation showed that the surface morphology of the dentin slices changed after etching as well as after Er:YAG laser pre-treatment with different energy and frequency values. The dentin tubules opened within a specific energy (50–200 mJ) and frequency (5–20 Hz) range. Beyond this range, the intertubular dentin showed cracks and structural disintegration. Shear strength tests showed no significant changes after acid etching. The shear strength increased significantly (P < 0.05) after Er:YAG laser pre-treatment compared with that of the control group. The shear strength increased within the same energy (50–200 mJ) and frequency (5–20 Hz) range as the tubule opening, but not significantly (P > 0.05). The most common mode of interface failure was adhesive (interface) failure, followed by mixed and resin cohesive failure.

Conclusions

Pre-treatment using Er:YAG laser opens the dentinal tubules without the formation of a smear layer and improves the bonding strength between the primary teeth dentin and the resin composites.

Effects of calcium hydroxide reagent on the bond strength of resin cements to root dentin and the retention force of FRC posts

The aim of this study was to determine the effects of calcium hydroxide (Ca(OH)₂) treatment on bond strength of resin cements to root dentin and retention force of fiber-reinforced composite (FRC) posts. Bovine root dentin was endodontically prepared and treated with Ca(OH)₂ for 7 days. Root dentin for bond strength test was adhered to resin-composite with resin cements. For pull-out test, posts consisting of FRC posts and resin-composites were fabricated and cemented to root. Shear bond and pull-out tests were performed using a universal testing machine. No significant differences in bond strength and post retention force were found between Ca(OH)₂ treated and untreated groups. Significant differences were found among the cements. A positive correlation was indicated between bond strength of cements and retention force of FRC posts. In conclusion, Ca(OH)₂ treatment on root dentin did not affect bond strength of resin cements and retention force of FRC posts.

Ceramic Veneers for Esthetic Restoration of Retained Primary Teeth: A 4-year Follow-up Case Report

Retained primary teeth in the smile zone can cause patient dissatisfaction, especially if associated with malposition of teeth. Orthodontic and prosthetic treatment options to treat the situation may not be accepted by some patients. Therefore, these patients tend to maintain their primary teeth and seek different esthetic options. Ceramic veneers may provide an esthetic treatment option to restore these teeth. However, the survival rates of ceramic restorations in such cases have not yet been established. This case report provides a step-by-step clinical description of the use of ceramic veneers for the restoration of retained primary canines and mild teeth malalignment, with a 4-year follow-up report, in a 28-year-old female patient. During restorative treatment, an effort was made to maintain the occlusion in group function to minimize stress and eliminate destructive forces on the retained primary teeth. After 4 years of function, the patient was still satisfied with the provided treatment.